The right time for DBS is when your medications still work, but not as well as they used to. Research shows that deep brain stimulation may be appropriate for people who have had Parkinson's for at least four years and at least four months of movement symptoms not well controlled by medications or medication side effects such as unintended movements (dyskinesia).1,2
Parkinson's symptoms get worse over time. The right time for DBS is when medications alone aren't providing enough relief, but still have some effect. The right time to talk with your doctor about DBS is now — so you know all your options and can act at the right time.
You're probably taking medications to help control movement symptoms like tremor (shaking), slowed movement (bradykinesia), and stiffness (rigidity).
One common Parkinson's disease medication, levodopa, is typically very effective at first, but less so over time. As Parkinson's progresses, doctors prescribe more or different medications, and have you take them more often. The higher doses may not bring the relief you need and can lead to side effects like nausea, dizziness, or unintended movements (dyskinesia).
If you wait until your medications no longer help, DBS will no longer be an option — so don't think of DBS as a last resort. Instead of just putting DBS off until someday in the future, talk with your doctor about it now. That way, you will be ready to start at the right time for you.
Watch for these signs that your medications are not working as well as they used to:
One day I could do needlework — the next day I couldn’t. At one point I was taking the maximum amount of drugs and feeling groggy and nauseous all the time.— Karen, receiving DBS therapy for Parkinson's disease
Schuepbach WMM, Rau J, Knudsen K, et al. Neurostimulation for Parkinson's disease with early motor complications. N Engl J Med. February 14, 2013;368:610-22 7.
Medtronic DBS Therapy for Parkinson's Disease and Essential Tremor Clinical Summary, 2015.